한빛사논문
- 조회128
Yun, Byungyoon MD, PhD1,6; Park, Heejoo BSc2; Ahn, Sang Hoon MD, PhD3,4,5; Oh, Juyeon BSc2; Kim, Beom Kyung MD, PhD3,4,5,*,a; Yoon, Jin-Ha MD, PhD1,6,*,a
1Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
4Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
5Yonsei Liver Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
6The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
aCorresponding Author: Beom Kyung Kim, MD, PhD, Jin-Ha Yoon, MD, PhD
Abstract
Objectives: New terminologies of metabolic dysfunction-associated steatotic liver disease (MASLD) have been developed. We assessed hepatocellular carcinoma (HCC) risk across MASLD and/or alcohol intake.
Methods: We included participants aged 40-79 years receiving a national health check-up from 2009 to 2010 in the Republic of Korea, classified as follows: non-MASLD, MASLD, MASLD with increased alcohol intake (MetALD; weekly alcohol 210-420 g for male and 140-350 g for female), and alcohol-associated liver disease (ALD; excessive alcohol intake with weekly alcohol ≥420 g for male or ≥350 g for female). The primary outcome was HCC incidence. HCC risk was estimated using multivariable Cox proportional hazard models.
Results: Among 6,412,209 participants, proportions of non-MASLD, MASLD, MetALD, and ALD cases were 59.5%, 32.4%, 4.8%, and 3.4%, respectively. During follow-up (median 13.3 years), 27,118 had newly developed HCC. Compared to non-MASLD, the HCC risk increased from MASLD (adjusted hazard ratio [aHR] 1.66, 95% confidence interval [CI] 1.62-1.71), MetALD (aHR 2.17, 95% CI 2.08-2.27) to ALD (aHR 2.34, 95% CI 2.24-2.45) in a stepwise manner. Furthermore, the older and non-cirrhosis subgroups were more vulnerable to detrimental effect of MASLD and/or alcohol intake, concerning HCC risk. Among the older, female, and cirrhosis subgroups, MetALD poses similar HCC risks as ALD.
Conclusion: HCC risk increased from MASLD, MetALD to ALD in a stepwise manner, compared to non-MASLD. For an effective primary prevention of HCC, a comprehensive approach should be required to modify both metabolic dysfunction and alcohol intake habit.
논문정보
- Research article
- 2024년 06월 (BRIC 등록일 2024-06-30)
- 국내 연구진
- 의약학 > 응용의학
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